OBJECTIVES The Columbia Suicide Severity Rating Scale (C-SSRS) has been developed into an electronic self-rated version (the e-CSSRS) in order to facilitate compliance with regulatory requirements for prospective monitoring of suicidal ideation and behaviours.  The e-CSSRS v2.0 for IVRS has been translated and linguistically validated for use in over 60 countries. Whilst translating and linguistically validating the scale it was noted that particularly in the Asia-Pacific region there were some challenging issues around the concept of suicide from a linguistic and cultural perspective. This study aimed to determine what these issues were and highlight how they were resolved.  METHODS Eighteen reports were reviewed from the Asia-Pacific region. The languages were: China-Mandarin, India-English, India-Gujarati, India-Hindi, India-Kannada, India-Malayalam, India-Marathi, India-Tamil, India-Telugu, Korea-Korean, Malaysia-English, Malaysia-Malay, Malaysia-Mandarin, Philippines-English, Philippines-Tagalog, Singapore-English, Singapore-Malay, and Singapore-Mandarin. Each report was reviewed for challenges relating to translation and cultural adaptation. RESULTS Across all reports specific homonymic confusions were encountered within two target languages: in Indian Hindi the same word is used for “pill” and “bullet”; in Singapore Malay the words for “end” and “saving” sound similar, occasioning confusion in prompts about attempts to end life. Translations were adapted to avoid these confusions. In two cases the use of a gun in suicide attempts was found to be rare or unknown: in Singapore English the relevant prompt was clarified to minimise confusion; for Malayalam for Kerala, where shooting is rare and hanging is common, “getting a gun” was changed to “getting a rope” wherever it appeared and for similar reasons “collecting pills” was changed to “collecting a poison.” CONCLUSIONS The e-CSSRS v2.0 IVRS is now available in for use in over 60 countries. Some issues were identified relating to translation and the methods of suicide in a small number of languages but these were resolved throughout the linguistic validation process.